Family hospital bed information (FBH) system running on tablet personal computer (PC) was developed from the analysis of 36 general practitioner′s requirements.The system shared information with the hospital information system (HIS).The establishment of FHB information management system and the mode of reviewing and editing medical records,prescription and personal health record on tablet PC improved the management efficiency and quality of FHB.

Objective To study the role of cutaneous nerve and protease activated receptor 2 (PAR2)in the development of pruritus in atopic dermatitis(AD).Methods Dermal sheets were prepared from chronically pruritic skin lesions of 7 patients with AD,as well as from the normal skin of 7 healthy human controls.Double labeled immunofluorescence was performed using mouse anti-protein gene product 9.5(PGP9.5)monoclonal antibody and rabbit anti-substance P(SP)polyclonal antibody to observe the morphological changes in cutaneous nerve fibers,and Image-Pro Plus 6 software was used to semiquantitively assess the length,diameter of nerve fibers,integral optimal density of PAR2 and SP in dermal sheets.Results Immunofluoresence double staining showed that PAR2 co-expressed with PGP9.5 or SP in cutaneous nerve fibers.Compared with the normal control skin,both the total length and average diameter of PGP 9.5-expressing nerve fibers were increased(11051.8±1900.9 μm vs 7264.0±2659.9 μm,4.23±0.15 μm vs 3.95±0.15 μm,both P＜0.01)in pruritic lesions,while only the average diameter of SP-expressing nerve fibers was up-regulated(3.99±0.20 μm vs 3.80±0.07 μm,P＜0.05),and the total length of them remained unchanged(4304.7±1455.0 μm vs 3380.0±1735.4 μm,P＞0.05).Also,increased integral optimal density was observed for SP and PAR in pruritic lesions in comparison with the normal control skin (27.71±16.52 vs 12.63±4.31.35.99±8.63 vs 22.69±9.56.both P＜0.05).Conclusion Our results indicate a hyper-plasia of cutaneous nerve fibers in chronic itchv skin lesions of AD and an increase in the expression of PAR2 and SP in the cutaneous nerve fibers,suggesting that the signal enhancement in PAR2 pathway may be related to the mechanism of pruritus in patients with AD.

Objective To investigate the expression and significance of E-cadherin and β-catenin in type Ⅰ endometrial carcinoma.Methods The expression of E-cadherin and β-catenin were detected by immunohistochemistry in 60 patients with type Ⅰ endometrial carcinoma and 10 normal endometrial tissues.The patients were followed-up postoperatively for the survival rate.Results Expression of E-cadherin and β-catenin in 10 normal endometrial tissues was all high expression,while those of both abnormal expression in type Ⅰ endometrial carcinoma with expression rates with 60.0 ％ (36/60) and 55.0 ％ (33/60),respectively,which were difference compared with both in normal endometrial tissues (P ＜ 0.05).The expression rates were markedly decreased in carcinoma with lymph node metastasis than those without lymph node metastasis.The proportions of abnormal expressions of E-cadherin and β-catenin were positively correlated with tumor grade and myometrial invasion in type Ⅰ endometrial carcinoma (P ＜ 0.05).The postoperative two-year survival rate in the patients with abnormal expression of E-cadherin and β-catenin were much lower than those with normal expression (P ＜ 0.05).Conclusions Abnormal high expression of E-cadherin and β-catenin may play important roles on generation and metastasis in type Ⅰ endometrial carcinoma.Both of them may be promising method for predicting invasion and metastasis and can be prognostic predictors in type Ⅰ endometrial carcinoma.

The first case of acquired syphilitic skull osteitis accompanied by syphilitic meningitis in China is reported.A 55-year-old female presented with a persistent distending pain of the frontal and occipital regions of the skull for two months.T1 weighted magnetic resonance imaging(MR1) showed muhiple lesions in the skull and linear enhancement of the meninge near the lesions.The serum and cerebrospinal fluid (CSF) were positive for Treponema pallidum particle agglutination assay (TPPA) and rapid plasma reagin circle card test(at the dilutions of 1∶32 and 1∶4 respectively).The levels of leukocyte and protein were 10 ×106/L and 0.82 g/L respectively in CSF.TP DNA was detected in the calvarial periosteum.Histopathological examination of the frontal bone showed focally destructive osteolytic lesions with obscure texture of the bone,hyperemia around the destructive bone tissue and in dura mater-like tissues,proliferation of interstitial fibrous tissue,swelling of endothelial cells and inflammatory infiltration predominantly composed of abundant plasma cells.After managed with routine treatment regimen for neurosyphilis,her headache was relieved 3 days later,nearly disappeared 15 days later,completely disappeared 30 days later.No similar headache recurred.A 5year follow up demonstrated a satisfactory long-term and short-term outcome.She was finally diagnosed with syphilitic skull osteitis complicated by syphilitic meningitis.

Objective To investigate the effect of valsartan on vascular endothelial function and brachial-ankle pulse wave velocity(baPWV)in patients with essential hypertension(EH).Methods Blood pressure,NO value and brachial-ankle pulse wave velocity were determined and analyzed in 30 patients with essential hypertension before and after therapy of valsartan.Results Both blood pressure and brachial-ankle pulse wave velocity wefe re-duced greafly(P<0.05 and P<0.01),while serum NO increased significantly(P<0.01)following valsartan thera-Py,and brachial-ankle pulse wave velocity was well correlated to serum NO(r=-0.71,P<0.01).Conclusions Valsartan is not onlv effective in the control of blood pressure,but also effective in reveming the impaired endothelial function and artery elasticity in patients with essential hypertension,at the same time brachial-ankle pulse wave ve-locity is also good surrogate of endlothelial functional improvement induced by Valsartan therapy.

Objective To study the impact of aging on the capability of lung stem cell steady-state maintaining and bronchial epithelial cells regeneration and differentiation during the repair of lung epithelial cells after naphthalene induced bronchial epithelialium injury.Methods The proportion of lung stem cells in mice after naphthalene treatment was analyzed by immunohistochemistry and FACS.The repair efficiency of lung epithelial cell in young and old mice was examined by immunohistochemistry staining and FACS.Results The data suggested that aging didn ’ t change the proportion of lung stem cells ( including the distal lung epithelial stem cells/progenitor cells and lung mesenchymal stem cells/progenitor cells) under normal physiological conditions.After naphthalene injury, more serious injury and decreased repairing capacity was observed in old group.Lung progenitor cells /total lung cells decreased during the repair process of lung bronchial epithelialium ( clara cell) injury.The ratio of regenerated cell to lung progenitor and stem cells were also significantly decreased in old group.Conclusion The regenerated capability of lung stem cells after lung bronchial epithelialium injury decreased with aging.This might be the reason of more incidence of lung injury and worse therapeutic results in the elder in clinic.

Objective To investigate the awareness,willingness,motivation,and influencing factors of outpatients for participating drug clinical trials,and provide references for decision-making of drug clinical trials.Methods An amnonymous survey was conducted in the departments of internal medicine,surgery,gynecology,and obstetrics of a randomly selected tertiary referral center,and the results were statistically analyzed.Results A total of 1 067 available questionnaires were received.The total awareness rate of clinical trials was 31.02％,which was closely correlated with age and the degree of education.40.86％ of respondents were willing to participate in drug clinical trials.And 55.28％ of them chose yes because of the willingness to contribute to the development of medical science.People having cognition on clinical trials had more willingness to participate in drug(OR:1.361,95 ％ CI:1.042-1.777).59.14％ of the respondents refused to participate in drug clinical trials,68.62％ of whom refusing to participate mainly worried about the safety of drugs.57.37％ of the respondents comfirmed that they might change their idea if experts were involved.41.33％ were willing to accept training about clinical trials.Conclusion Investigators'overall cognition on clinical trials is closely correlated with the willingness to participate in drug clinical trials.There should propagandize drug clinical trials to make sure the improvement of drug clinical trial progress.

Objective To evaluate the safety limits of amygdalin in the Chinese patent medicines and Chinese herbal medi-cines,so as to provide reference for establishing the standard in the safety limits of endogenous cyanide glycosides as toxic ingredients. Methods The toxicity differences between D-amygdalin and L-amygdalin were explored by CCK-8 assay. The daily safe dose of amyg-dalin was deduced by the no-observed-adverse-effect level(NOAEL)of cyanide. Based on the deduced results,the safety limits of amygdalin in thirty-six Chinese patent medicines and three different kinds of Chinese herbal medicine were calculated. Results The half maximal inhibitory concentration of D-amygdalin and L-amygdalin was(3.5±2.0)and(6.6±0.4)mmol/L,respectively,and the daily safe dose of amygdalin was 104.30 mg. Conclusion The toxicity of D-amygdalin was approximately two times that of L-amygda-lin. To establish the safety limits of amygdalin,the sum content of the epimer could be regarded as the D-amygdalin itself to enlarge the safety scope. The content of amygdalin of three Chinese patent medicines was determined to exceed the maximum safety limit for all measured batches,indicating some kind of safety risk. Moreover,in the researches on safety limit establishment,the toxicity-alleviat-ed processing effect should be included.

Objective To evaluate the effect of recombinant human tumor necrosis factor receptor type Ⅱ:IgG Fc fusion protein (rhTNFR:Fc,trade name Etanercept) combined with methotrexate on levels of interleukin-17A (IL-17A) and tumor necrosis factor-α (TNF-α) in the serum and mononuclear cells of patients with moderate to severe plaque psoriasis.Methods A total of 30 patients with moderate to severe plaque psoriasis were enrolled from Department of Dermatology of Tenth People's Hospital of Tongji University between August 2014 and February 2016,and then were randomly and equally divided into Etanercept group and Etanercept + methotrexate group.The treatment lasted 24 weeks.Fifteen healthy blood donors served as healthy control group.Enzyme-linked immunosorbent assay (ELISA) and real-time quantitative PCR were performed to measure the serum levels and mRNA expression of IL-17A and TNF-α,respectively,in the patients of the above two groups before and after the treatment.Results Before the treatment,the serum levels of IL-17A and TNF-ct,as well as the mRNA expression of IL-17A and TNF-α in peripheral blood mononuclear cells (PBMCs),were all significantly higher in all the patients than in the healthy controls (all P ＜ 0.05).After the treatment,compared with the Etanercept group,the Etanercept + methotrexate group showed significantly lower serum levels of IL-17A (142.67 ± 14.82 vs.163.54 ± 23.18,P ＜ 0.05) and TNF-α (70.07 ± 25.02 vs.91.98 ± 14.62,P ＜ 0.05),as well as lower mRNA expression of IL-17A (1.12 ± 0.33 vs.1.56 ± 0.77,P ＜ 0.05) and TNF-α in PBMCs (2.50 ± 1.04 vs.3.61 ± 2.14,P ＜ 0.05).Conclusion Etanercept combined with methotrexate is superior to Etanercept alone in the treatment of psoriasis,and can reduce treatment duration and improve therapeutic effect,likely by down-regulating the expression of IL-17A and TNF-α.

Objective To observe the efficacy of combination therapy of calcium dobesilate dispersible and monosialotetrahexosylganlioside sodium on interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in elderly patients with painful diabetic peripheral neuropathy.Methods From January 2012 to May 2017,in the Second People's Hospital of Lianyungang 70 patients of painful diabetic peripheral neuropathy,aged ≥60 years,were analyzed in this study.They were randomly divided into observation group (35 cases) and control group (35 cases).The observation group was treated with 40mg monosialotetrahexosylganlioside sodium dissolved in 250mL physiological saline,intravenous infusion per day,and oral calcium dobesilate dispersible 0.5g twice a day for two weeks.The control group was treated with methylcobalamin injection 0.5mg per day for two weeks.The clinical treatment effects and levels of IL-6 and MCP-1 were observed and compared between the two groups.Results After two weeks of treatment,the MDNS and MNSI scores of the observation group [(13.09 ± 5.38)points,(2.53 ± 1.19)points] were significantly lower than those of the control group [(18.31 ± 6.13) points,(4.19 ± 1.05) points,t =2.036,2.365,all P ＜ 0.05] and those before treatment [(21.26 ± 4.28) points,(5.40 ± 0.89) points,t =3.251,3.698,all P ＜ 0.05].The VAS-PI scores in the observation group [(6.24 ± 1.25) points,(4.13 ± 1.69) points] were significantly lower than those in the control group[(7.26 ± 1.28) points,(6.34 ± 2.65) points] at the first and second week (t =3.265,5.395,all P ＜ 0.05).The serum levels of inflammatory cytokines IL-6 and MCP-1 in the observation group [(15.16 ±0.88) ng/L,(157.19 ± 11.22) ng,/L] were significantly lower than those in the control group[(17.87 ± 1.19) ng/L,(198.21 ± 12.07)ng/L,t =2.152,1.365,all P ＜0.05]and those before treatment[(20.26 ± 1.05) ng/L,(260.44 ± 13.63) ng,/L,t =1.235,0.965,all P ＜ 0.05].Conclusion Combination of calcium dobesilate and mono-sialotetrahexosyl ganglioside may alleviate the sensory and pain sensations in patients with painful diabetic peripheral neuropathy,possibly by reducing the level of inflammatory cytokines IL-6 and MCP-1.